Vnitřní lékařství, 1992 (vol. 38), issue 4
[The psychosomatic approach in clinical practice].
R Honzák
Vnitr Lek 1992, 38(4):313-316
The author summarizes demands essential for successful implementation of the psychosomatic, i.e. biopsychosocial approach in everyday clinical practice. With regard to the complete shortage of comprehensively conceived psychosomatic centres, the author considers it useful to replace extra-mural psychiatric and psychological services to a maximum extent by consultant ("liaison") psychiatrists and psychologists. Team cooperation of specialists, mostly with a biomedical orientation, with specialists from the psychosocial sphere is an asset for patients as well as for medical thinking. This collaboration gives specialists of both represented models some...
[Multicenter study of isradipine in the treatment of hypertension].
J Widimský, R Dzúrik, N Fe»kovská, I Balazovjech, J Kvasnicka, Z Lupínek, O Mayer, V Pidrman
Vnitr Lek 1992, 38(4):317-325
MIS is a one-year Multicentre Isradipine Study of the treatment of essential hypertension, in which participated seven centres in Czechoslovakia. The study comprised 144 patients with mild or medium severe hypertension. Isradipine belongs into the group of dihydropyridine derivatives with a high specific and low non-specific affinity to dihydropyridine binding sites of the L-type of calcium channels. After a four-week placebo period isradipine treatment (2.5 mg (1/2 tablet twice a day/was started. This dose increased to 5 mg (1 tablet twice a day) unless normalization of the diastolic pressure was achieved by a smaller dose. Monotherapy with isradipine...
[Genealogic study of hypertrophic cardiomyopathy in the Czech population].
P Gregor, M Cerný
Vnitr Lek 1992, 38(4):326-331
In order to test the type of heredity and to assess further genealogical characteristics in our population the authors examined 105 families with hypertrophic cardiomyopathy. The families were subjected to clinical, electrocardiographic and echocardiographic examination of relatives (72% grade 1 relatives) as well as to a genealogical and psychological examination. For the proband's siblings the empirical risk of disease was 24%, in male probands it wts four times higher for brothers than sisters, in female probands it was three times higher in sisters. The sex ratio of six siblings in men was 20:4, in women 3:14. For children the risk was substantially...
[Creatine kinase and lactate dehydrogenase in the early diagnosis of acute myocardial infarct].
F Moscovic, M Takác, R Polcin, J Ponist, P Moscovic
Vnitr Lek 1992, 38(4):332-336
The authors investigated in a group of 504 patients--357 men and 147 women with acute myocardial infarction on admission to hospital--the relationship between the ECG finding and values of catalytic concentrations of isoenzymes CK-MB and LD-1 LD-2. They found that isoenzymes CK-MB and LD-1 LD-2 are a more sensitive indicator of acute IM than the ECG tracing. Not even a negative ECG tracing when the total catalytic concentrations of CK and LD are not elevated rules out the possibility of acute myocardial infarction.
[Magnesium loading test in cardiovascular diseases].
V Spisák
Vnitr Lek 1992, 38(4):337-344
The author presents an account of results of the magnesium loading test and its method, from a group of 50 patients with cardiovascular diseases. The magnesium loading test reveals shortage of bodily reserves of magnesium (mg) by calculating the percentage of Mg retention. In a group of examined subjects the author found a high percentage of Mg retention (on average 68%) which suggests an unequivocal deficiency of bodily Mg reserves in this group of patients. At the same time changes of serum concentrations and urinary excretion of other investigated minerals are discussed. As compared with other methods of assessment of Mg bodily reserves, the loading...
[Drug therapy in vascular occlusions of the lower extremities].
M Emmerová, V Treska, J Valenta, M Novák, Z Chudácek
Vnitr Lek 1992, 38(4):345-351
The authors report their three-year experience with application of thrombolytic treatment in 31 patients with vascular occlusions of the lower extremities. They were successful in two thirds of the patients. The authors analyze the advantages and shortcomings of systemic or selective administration of antithrombotic therapy. Concurrent administration of hyperbaric oxygen is a rational therapy.
[Diabetic osteopathy. Favorable effect of treatment of osteomalacia with vitamin D and calcium on high blood glucose levels].
J Kocián
Vnitr Lek 1992, 38(4):352-356
A group of 61 diabetics (incl. 35 treated by diet alone and 26 who were treated also by oral antidiabetics) with associated osteomalacia were treated with vitamin D (dosage 42,000 to 85,000 i. u. per day) and calcium (470-700 mg/day). After six weeks of this treatment the serum calcium level rose on average by 0.15 mmol/l and the blood sugar level declined on average by 1.68 mmol/l. A linear negative correlation was proved between these two parameters. The fasting blood sugar level declined in 53 subjects (86.88%) and only in five patients (8.19%) the blood sugar level increased, in three subjects (4.91%) it did not change. Possible explanations of...
[Plasma viscosity. The effect of plasma proteins].
J Mayer, Z Pospísil, J Litzman
Vnitr Lek 1992, 38(4):357-364
The authors assessed the plasma viscosity by means of a capillary viscosimeter of their own design and assessed at the same time the concentration of 22 plasma proteins or lipids. Based on the results of these examinations it proved possible to elaborate an original equation which describes the plasma viscosity as a function of the concentration of fibrinogen, alpha-2-globulins (and among them most probably haptoglobin), gammaglobulins, IgA and IgM. The authors discuss in detail the importance of this finding for clinical haemorheology.
[Free oxygen radicals in patients with hyperlipoproteinemia].
V Soska, A Zechmeister, J Siegelová, A Lojek
Vnitr Lek 1992, 38(4):365-368
The authors investigated the effect of hyperlipoproteinaemia on the formation of free oxygen radicals to which a significant role in the genesis of atherosclerosis is ascribed. They cause among others peroxidation of blood lipids with formation of lipoperoxides with a higher atherogenity. Using the method of luminol-dependent chemiluminiscence, their spontaneous and activated production in phagocytic blood cells was examined in a group of patients investigated on a long-term basis on account of hyperlipoproteinaemia (n = 24). The results were compared with a group of healthy subjects (n = 20); concurrently also blood lipids were examined. The authors...
[Antibodies against gastric parietal cells and thyroglobulin in various diseases in humans].
E Lakata, M Kunay, E Merstenová, J Kaffanová
Vnitr Lek 1992, 38(4):369-377
The authors examined antibodies against antigen of gastric parietal cells using the method of reaction of complement-binding and the immunofluorescence test in 662 patients. Concurrently they examined in 443 patients of this group also antibodies against thyroglobulin. The group comprised 312 men and 350 women. For statistical evaluation the chi 2 test was used. Antibodies against the antigen of parietal cells were positive at the level of significance p less than 0.05 in the group with other diseases, at the level of significance of p less than 0.01 in dyspeptic syndrome, and at the level of significance p less than 0.001 in hypothyroidism and in...
[Asymptomatic cholecystolithiasis in an ultrasonography study from Trencín].
J Bielik
Vnitr Lek 1992, 38(4):378-383
The author examined 1952 girls and women aged 15 to 92 years by ultrasonography. The incidence of cholecystolithiasis in the group without complaints was 8.19% in the group with atypical complaints it was 17.67% and in the group with typical complaints it was 75.0%. The ratio of asymptomatic cholecystolithiasis of the first two groups combined was 67.0% of the total. The ratio of cholecystectomies in the total number of cases with cholecystolithiasis was 30.9%. The clinical manifestation of cholecystolithiasis is influenced greatly by genetic factors, i.e. symptomatic lithiasis in the mother. Prophylactic cholecystectomy in case of asymptomatic cholecystolithiasis...
[Pulmonary embolism as a rare complication of a contusion in the inguinal region].
J Vancík, I Tkác, M Takác, J Lazúr
Vnitr Lek 1992, 38(4):384-387
In the submitted case-history the authors describe the clinical case of an adolescent patient who developed phlebothrombosis of the right ileofemoral area one year after a blunt injury in the scrotal and right inguinal area. The symptoms of pulmonary embolism were detected sooner than the symptoms of phlebothrombosis. Two-dimensional echocardiography provided valuable information when the authors monitored the dynamics of changes in acute cor pulmonale and the effect of administered treatment.
[Quality control in hematology].
J Berger
Vnitr Lek 1992, 38(4):388-394
Qualified quality control is a necessary part of modern haematology: we cannot deem laboratory results reliable until effective quality checking is included. Quality assessment includes external (national, regional) and internal (intra-laboratory) control. We suggest to found a Czech national external quality control agency for haematology based on principles which were declared by the World Health Organization. Internal control includes correct identification of samples, analytical control (standardization of test, evaluation of accuracy and precision) and biological quality control (history of patient's characteristics, relation to other laboratory...
[Present views on the diagnosis of cavernous hemangioma of the liver using ultrasound].
V Růzek, T Vaněcek
Vnitr Lek 1992, 38(4):395-401
The submitted review deals with morphometry, normal sonographic anatomy and the position of ultrasonography in the diagnosis of cavernous haemangiomas of the liver. The authors draw attention to the contemporary equipment used and analyze the position of other diagnostic methods in the diagnosis of cavernous haemangiomas of the liver. They discuss also the problem of percutaneous biopsy of the liver when this benign tumour is suspected. Finally the authors recommend the best procedure in the diagnosis of cavernous haemangiomas of the liver.
[Modern development of cardiac pacing].
J Lukl
Vnitr Lek 1992, 38(4):402-408
In the submitted review the author presents after a historical introduction the contemporary possibilities of permanent pacing. He mentions the main reasons why a fixed rate pacing without atrioventricular synchronization is unphysiological and led to the development of dual chamber DDD pacemakers and ventricular pacemakers with a variable frequency of pacing. The main contribution of this so-called physiological pacing is an increase of the cardiac output and the work capacity of patients, as compared with fixed rate pacing. The author present also examples of diagnostic and antitachycardiac stimulation and discusses possibilities of their combination...